Monday, May 26, 2014

Back in the early 1980’s I studied language samples of children who has been identified as severely intellectually disabled. They were children I worked with at the time in a state developmental center. What I found will not surprise anyone in the field. Language samples were populated mostly by nouns and some verbs, and utterances were brief. I presented my findings at an ASHA convention as a question, “What are we teaching [them]?” I may not have known a lot about core vocabulary back then, but I knew we were doing something wrong. Yet here we are decades later and overwhelmingly, children with significant disabilities and complex communication needs are still taught primarily to label and request.

So, where should language development begin with children with language and communication disabilities? Beginning, or emergent, communicators use single word utterances, if they use words at all. And certainly labeling has its place in beginning language development. However, nouns are not potent communicators. Words that direct actions are much more useful and more often used - words like: more, stop, give, help.

As the child’s vocabulary grows to somewhere more than 50 words, two word combinations begin to appear; inconsistently at first. Combining the first 25 core words accounts for most of these two-word combinations. Much can be said using these 25 early core words just by combining them; including: what that, want that, that mine, stop that, don’t go, don’t do, all gone, go here, it on, etc. Some 3 word combinations begin to be used soon. Requesting and directing another’s actions are still at the top of the intents used, but negation and protest are also present.

As the child’s language begins to grow, more meaning is added to words using morphological markers; such as adding -s to nouns and -ing to verbs. Grammar is still developing and phrases still sound “wrong.” Tenses are beginning to develop, as well as the addition of some concepts to vocabulary.

I’m not going to go any further here, because if your child has gotten this far, then you know they are headed in the right direction, and need to keep adding vocabulary and syntactical skills to become effective communicators. But if, instead, your child is stuck at the single word stage, make sure that the intervention they are receiving is truly providing adequate vocabulary to meet their communication needs. Make sure the focus isn’t on nouns, or on labeling and requesting to the loss of other intents. Make sure that core words are being introduced in multiple contexts, and that they are truly engaged in communicating.

Wednesday, May 21, 2014

Summer is almost here and with it may come an end, or at least a decrease, in services to kids. While collaboration with parents is key to a child’s success all year round, it is especially important now to work with parents to prevent that “summer slide.”

Students with language disorders need consistent input and intervention all of the time, and most of our parents have gotten pretty darned good at it. But many would also benefit from and welcome additional tips and tricks, materials, ideas, and ways to keep their kids communicating effectively over the summer.

And in a true collaborative effort, you will also learn more about this child you see every day - or twice a week. Parents know so much about their children. We may be the “experts” on our field, but they are the expert on their kids. Share what you know. Share what works and what doesn’t. And share whatever information is going to make this child be successful.

There are a lot of games, exercises, drills, or tasks we can and do recommend to parents. I prefer to tell parents to keep on reading to their child, and while reading, look for ways to build language and communication skills.

All kids benefit from being read to. We all know that. But sometimes our kids with complex communication needs don’t get as much reading input. Or our struggling readers are encouraged to read on their own to build fluency, and miss out on having age appropriate texts read to them.

When collaborating with parents about how to keep language skills growing over the summer, please encourage them to read more. Give them ideas on ways to ask questions, and ways to interact with text (check out that blog post above for specific examples of question types).

Having a good, strong partnership with parents and truly elaborating has so many benefits for the child. Ideas that may begin in the classroom have a chance to grow in less structured environments of a summer vacation. Let me know if you have positive tips for good collaboration efforts.

Monday, May 12, 2014

I know it is still snowing in some places and it has been a really long winter for lots of you. Here in Southern California we never really had a winter this year. And now the temperatures are soaring!In any case, school is almost over for the year. Hard to believe.For many of our students, time away from class and therapies can mean some regression. In order to keep up those communication skills, last summer I put together a simple calendar of activities for parents to use as a starting place for daily language practice.I've got a new one for this summer,too. I thought I'd share last year's with you.

And, here is this year's, with 2 calendar months full of expressive activities to keep language growing.

Friday, May 2, 2014

My resource Language Fun and Story Elements with the book Aunt Isabel Tells a Good One (by Kate Duke) will be a Flash Freebie on Teacher's Notebook tomorrow from 4-5 pm CST.
Limited downloads, so come early!here

Thursday, May 1, 2014

I wanted to touch this topic again, as there continues to be a lot of confusion from parents, teachers, aides and SLPs about how, exactly, to talk to AAC users to help them communicate more. Being a partner to an AAC user requires us to be on our toes. We need to think about what we're saying, what they're doing, how we can help them to do something more or different, whether we're interpreting what they're doing correctly..... It seems like a lot.So, here are some more basic tips:

Good Communication Partners:

create a positive communication environment

respond to all communication attempts

use the child’s AAC system to communicate to them

Creating a Positive Communication Environment

There is a positive communication environment when we respond to all of a child’s communication attempts, provide support as needed, focus on positive results, and find solutions to challenges. Even when you respond to an undesirable behavior, if you do so while also modeling how to use the correct message in the AAC system you take advantage of a communication opportunity.

As much as possible, do NOT ask yes/no questions, do NOT ask closed-ended questions

DO ask Wh-question or other open-ended questions. If necessary, ask multiple choice questions.

Strategies to create opportunities to communicate include providing choices, sabotaging the environment, giving small amounts of desired item/activity, briefly delaying access, using pause time, using fill-in-the- blank activities.

Respond to all Communication Partner’s Attempts:

All children communicate. They don’t necessarily all communicate symbolically - that is, with pictures, words, text. And some of their non-symbolic communication is undesirable.

Think about how this child responds to his/her own name; what (s)he does when a routine is interrupted; what (s)he does when wanting an item, action, attention, or help; or tells you when something is wrong.

What we’re talking about is how this child communicates to reject/protest, request, comment. Those are some of the main, early functions of communication. The earliest communication behaviors are social regulatory - regulating another’s actions.

What we need to do is to respond to those other communication behaviors, while shaping them into more acceptable or understandable forms.

The more you practice using the aac system during real contexts, and increase the number of those contexts in which you use the aac system, the more automatically the child will learn to use the system.

Use the AAC System to Communicate TO the Child:

Aided Language Stimulation - also called Partner Aided Input - is crucial to the child learning to use their aac system.

Language is learned through models. Children learn spoken language by listening to others using it. A child using picture-based communication is learning an entirely different language. They need to see models of people using it effectively. And models provided in response to their communication is most powerful.

Facilitating Communication:

provide access to the aac system - it needs to be available all of the time. This is how this child “talks” and (s)he needs to know that communication is valued enough to be there whenever it is needed

provide AAC models - use aided language stimulation as much as possible. When asking questions during an activity, highlight key words by using the aac system

provide opportunities for the child to take a turn - i.e. by pausing after each turn you take. Don’t be the only one “talking”

pause/expectant delay - give the child time to process, time to formulate a response. Looking expectant while pausing lets the child know you expect a response

ask open-ended questions - and wait for the answer before you provide it; if necessary, then you can answer the question then provide a prompt for the child to imitate the answer. Asking Wh-questions instead of yes/no questions allows the child to learn higher-level responses.

prompting those responses - providing verbal prompts lets the child know what they are supposed to do.

When do I do Each of Those Things?

Begin with routine activities. Many routine activities have a set beginning - middle - end that are predictable , use words that are predictable. This makes it easier for the child.

Other activities are a little less predictable but can easily provide communication opportunities.

Sample activity (based on Kent-Walsh and Binger):

Read from a book (a 2-pg. spread) + Model using the AAC system. Then PAUSE

Ask a question + Model using the AAC system. Then PAUSE

Answer the question + Model using the AAC system. Then PAUSE

If necessary and appropriate to the target goal: Prompt a response.

Take turns with other adults role playing how to do this so it becomes automatic.

Start using ALgS (Aided Language Stimulation) with one activity. When you’re comfortable, add another. activity/time Keep adding activities throughout the day until the strategies are used all of the time.

Keep track of the need for new vocabulary. By the time you have increased the number of contexts, you may find that there is more vocabulary that you need. Have a plan for how to keep track of this. For example, some classrooms keep a list on a clip board for each applicable student, staff write down words as they come up. The list is given to the person who updates the system every day/week/2 weeks - as appropriate.

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